JP2023529875A - Lenses with asymmetric projection to treat astigmatism - Google Patents

Abstract

The stimulation is configured to treat astigmatism associated with changes in retinal thickness, independently or in combination with treatments for myopia. In some embodiments, the stimulation pattern is aligned with the astigmatism axis of the eye to reduce ocular growth associated with the astigmatism axis. In some embodiments, the device is configured to direct light to a region of the retina outside the macula associated with the astigmatism axis of the eye. In some embodiments the intensity is modulated to provide that effect. A lens, such as a contact lens or a spectacle lens, has a light source and focusing optics that cooperate to project an anteriorly or posteriorly defocused image onto the retina at a location that is decentered with respect to the fovea. , a projection unit, etc., with a plurality of light sources.

Description

(Cross reference to related applications)
119(e), filed June 8, 2020 and entitled "LENS WITH ASYMMETRIC PROJECTION TO TREAT ASTIGMATIS M", which is incorporated by reference in its entirety. The benefit of application Ser. No. 63/036,170 is claimed.

The subject matter of this application is filed on July 26, 2019, entitled "ELECTRONIC CONTACT LENS TO DECREASE MYOPIA PROGRESSION", published as WO2020/028177A1, the disclosure of which is incorporated herein by reference in its entirety. to International Patent Application No. PCT/US2019/043692, filed on Oct. 25, 2019, and U.S. Patent Application No. 62/925,948, entitled "DEVICE FOR PROJECTING IMAGES ON THE RETINA". Related.

The eye refracts light and focuses images onto the retina of the eye to provide vision. However, in some instances the refraction of light may be sub-ideal, which may lead to refractive error of the eye. Refractive errors in the eye can be related to the length of the eye and the curvature of the cornea. For example, eyes with longer axial length tend to be myopic, eg, nearsighted, and eyes with shorter axial length tend to be hyperopic, eg, farsighted. Eyes with irregularly shaped corneas tend to have astigmatism.

Astigmatism is generally associated with imperfections in the curvature of the cornea or lens of the eye. In an astigmatic eye, the cornea and lens are often curved substantially equally in all directions. However, in eyes with astigmatism, the cornea is often curved differently along different meridians of the cornea. A properly curved lens and cornea help focus light rays sharply onto the retina at the back of the eye.

A patient may have corneal astigmatism when the cornea has an irregular shape, such as a toric shape, that is not curved equally in all directions. Astigmatism can blur or distort a patient's vision for both near and far objects.

Studies related to the present disclosure suggest that the retinas of many species, including humans, grow in response to defocused images and to reduce the blur caused by defocusing. Although the mechanisms of growth signal generation are still the subject of investigation, an observable phenomenon of the response of retinal tissue to growth signals is the change in choroidal thickness. A defocused image can change the choroidal thickness, which can be related to changes to the axial length of the eye and the location of the retina relative to the cornea and lens.

Astigmatism, myopia, and hyperopia are refractive errors of the eye that can be corrected with refractive lenses and surgery. However, at least some of these approaches may be quasi-ideal in at least some respects. For example, some patients may be intolerant of contact lenses or eyeglasses, and refractive surgery may present risks. Uncorrected astigmatism can affect a person's ability to complete and fully participate in schoolwork, sports, and other activities. Spectacle lenses, contact lenses, and refractive surgery can be used to treat refractive errors of the eye, such as astigmatism, but such devices must be worn to correct the error. Surgery is associated with risks such as infection and loss of vision. These previous approaches typically do not address ocular length, which can be associated with retinal diseases such as retinal detachment as the patient ages.

Although image defocusing may play a role in changes in choroidal thickness and axial length of the eye, previous methods and devices are quasi-ideally suitable for dealing with astigmatism. For example, pharmaceutical treatments have been proposed to treat myopia associated with axial length growth, but these treatments can, at least in some instances, have sub-ideal results. Light has been proposed as a stimulus for reducing changes in refractive error, but previous devices have, at least in some instances, been quasi-ideal for treating astigmatism associated with changes in retinal thickness. may be suitable.

Therefore, new approaches are needed to treat astigmatic refractive error in the eye.

The disclosed method and apparatus can treat astigmatism using retinal stimulation. In some embodiments, stimulation is configured to treat astigmatism associated with changes in retinal thickness, independently or in combination with treatments for myopia. In some embodiments, the stimulation pattern is aligned with the astigmatism axis of the eye to reduce ocular growth associated with the astigmatism axis. In some embodiments, the device is configured to direct light to a region of the retina associated with the astigmatism axis of the eye outside the macula. In some embodiments, stimulation intensity is modulated to provide that effect. Stimulation can be provided in a number of ways, but in some embodiments an anteriorly or posteriorly defocused image where a lens, such as a contact or spectacle lens, is decentered with respect to the fovea. It is configured with a plurality of light sources, such as a projection unit, having a light source and focusing optics, which cooperate to project the on the retina. In some embodiments, stimulation promotes choroidal growth, which in children and young adults can slow scleral growth near the location of stimulation. In some embodiments, the differential growth rate causes the eye to grow such that eye growth reduces the patient's astigmatism.
(embedded by reference)

All patents, applications, and publications referenced and identified herein are hereby incorporated by reference in their entirety, and if referenced anywhere in this application, all references are shall be deemed to be fully incorporated by

A better understanding of the features, advantages, and principles of the present disclosure may be obtained by reference to the following detailed description and accompanying drawings, which describe illustrative embodiments.

FIG. 1 shows a soft contact lens, according to some embodiments.

FIG. 2 shows a soft contact lens with a built-in light source, optics, and electronics for projecting an image with defocus onto the periphery of a user's retina, according to some embodiments.

FIG. 3 shows the mechanical integration of the functions of the contact lens components as in FIG.

FIG. 4A shows an optical configuration in which the optical path length is increased by folding the optical path with two mirrors, according to some embodiments.

FIG. 4B shows a ray-tracing simulation of the optical configuration shown in FIG. 4A, according to some embodiments.

FIG. 5A shows an optical configuration comprising a lens for focusing light onto the retina, according to some embodiments.

FIG. 5B shows a ray tracing simulation of the optical configuration shown in FIG. 5A, according to some embodiments.

FIG. 6A shows a light pipe for increasing optical path length, according to some embodiments.

FIG. 6B shows a ray tracing simulation of the optical configuration shown in FIG. 6A, according to some embodiments.

FIG. 7A shows a spectacle lens-based retinal stimulation device comprising a display and a housing containing electronics for operating the ocular display, according to some embodiments.

FIG. 7B shows a spectacle lens-based retinal stimulation device as in FIG. 10A, in which the eye is moving and different display elements are activated in response to eye movement, according to some embodiments. It is

FIG. 8 illustrates a method of treating refractive error in an eye, according to some embodiments.

FIG. 9A shows a soft contact lens with a built-in light source, optics, and electronics for projecting an image with defocus onto the periphery of the wearer's retina, according to some embodiments.

FIG. 9B shows a soft contact lens with a built-in light source, optics, and electronics for projecting an image with defocus onto the periphery of the wearer's retina, according to some embodiments.

FIG. 10 shows a spectacle lens in which groups of pixels are symmetrically oriented about an axis to treat astigmatism, according to some embodiments.

DETAILED DESCRIPTION The following detailed description provides a better understanding of the features and advantages of the inventions set forth in this disclosure according to the embodiments disclosed herein. While the detailed description contains many specific embodiments, these are provided by way of example only and should not be construed as limiting the scope of the inventions disclosed herein.

The methods and devices of the present disclosure can be configured in a number of ways to provide membrane stimulation as described herein. The methods and apparatus of the present disclosure can be used for ophthalmic devices, TV screens, computer screens, handheld mobile computing devices, tablet computing devices, smartphones, wearable devices, spectacle lens frames, spectacle lenses, eyepiece displays, head mounted displays, goggles , contact lenses, implantable devices, corneal onlays, corneal inlays, corneal prostheses, or intraocular lenses, or any other combination with many previous devices. Although specific reference is made to spectacles and contact lenses, the methods and apparatus of the present disclosure are well suited for use with any of the devices described above, and one of ordinary skill in the art will recognize that one of the components of the present disclosure is One or more will readily understand how to become interchangeable between devices based on the teachings provided herein.

Studies related to the present disclosure show that changes in choroidal thickness in response to stimulation can be localized to regions near the stimulated region, which according to some embodiments is somewhat localized suggesting that it may provide a response. In some embodiments, the change in one or more of the choroid or sclera comprises a differential change, in which the change in one or more of the choroid or sclera comprises: Larger near the stimulus region than the corresponding region remote from the stimulus (eg, corresponding location on the 90 degree axis from the stimulus region).

FIGS. 1 and 2 show a contact lens 10 or the like configured to project a defocused image onto the retina, away from the central cortex, including the macula, to stimulate changes in choroidal thickness. describe the lens of While reference is made to contact lenses, lens 10 may be used for projectors, ophthalmic equipment, TV screens, computer screens, handheld devices such as smartphones, spectacle lenses, ocular displays, head-mounted displays, wearable devices such as goggles, contact lenses, corneas, etc. It may comprise a lens of one or more of an onlay, a corneal inlay, a corneal prosthesis, or an intraocular lens.

In some embodiments, contact lens 10 comprises a first axis of astigmatism 80 and a second axis of astigmatism 81 . Multiple light sources, such as projection unit 12, are arranged with respect to the astigmatism axis to provide different amounts of stimulation to different regions of the peripheral retina. In some embodiments, the light source, such as projection unit 12, is positioned along the astigmatism axis, although the light source may be positioned elsewhere. The light source can be configured to provide different amounts of stimulation to the peripheral retina according to the refractive error of the eye. In some embodiments, the light source is directed along different axes to facilitate different changes in choroidal and scleral tissue corresponding to different changes in axial length, as described herein. configured to provide different amounts of illumination. The contact lens may comprise a rotatably stabilized contact lens, wherein the light source is directed onto the contact lens so as to correspond to the astigmatism axis of the eye when the lens is stabilized on the eye, for example. can be located in The contact lens may comprise an optic zone configured to correct astigmatic ametropia according to first axis 80 and second axis 81 .

The present contact lens 10 comprises a base or carrier contact lens with built-in electronics and optics. Base soft contact lens 10 is made from biocompatible materials such as hydrogels or silicone hydrogel polymers that are designed to be comfortable for sustained wear. The contact lens has a maximum overall transverse distance, eg diameter 13 . A biocompatible material can encapsulate the components of the soft contact lens 10 . In some embodiments, contact lens 10 has a central optical zone 14 designed to cover the pupil of the wearer's eye under many lighting conditions. In some embodiments, the optical zone comprises a circular zone defined with radius 15 . In some embodiments, multiple projection units 12 are located at a distance 17 from the center of the optical zone. Each of the plurality of projection units 12 has a transverse distance 19 . In some embodiments, the distance between the projection units is sized to place the projection units outside the optical zone and stimulate the peripheral region of the retina, but the projection units are also placed inside the optical zone. In place, the peripheral retina can be stimulated as described herein.

The optical zone 14 can be appropriately sized with respect to the eye's pupil and lighting conditions during treatment. In some embodiments, the optic zone comprises a diameter of 6 mm, for example when the contact lens is configured for daytime use. The optical zone 14 may have a diameter within the range of 6 mm to 9 mm, such as within the range of 7.0 mm to 8.0 mm. Central optical zone 14 is designed to provide emmetropic correction or other suitable correction to the wearer, and may be provided with both spherical and astigmatic correction. The central optical zone 14 is surrounded by an outer annular zone such as a peripheral zone 16 of width within the range 2.5 mm to 3.0 mm. The peripheral zone 16, sometimes referred to as the hybrid zone, is primarily designed to provide a good fit to the cornea, including good alignment and minimal deviation. The outer annular zone is surrounded by an outermost edge zone 18 of width in the range of 0.5 mm to 1.0 mm. The optical zone 14 is configured to provide refractive correction and can be, for example, spherical, toric, or multifocal designs with 20/20 or better visual acuity. The outer annular zone around the optic zone 14 is configured to match the corneal curvature and includes a rotational stabilization zone for translational and rotational stability, while the contact lens 10 on the eye following a blink. May allow movement. Edge zone 18 may have a thickness in the range of 0.05 mm to 0.15 mm and may terminate in a wedge shape. The overall diameter 13 of the soft contact lens 10 can be in the range of 12.5mm to 15.0mm, such as in the range of 13.5mm to 14.8mm.

Contact lens 10 includes multiple built-in projection units 12 . Each of the plurality of projection units 12 comprises a light source and one or more optical systems for focusing light in front of the retina as described herein. Each optical system may comprise one or more of a mirror, multiple mirrors, a lens, multiple lenses, a diffractive optic, a Fresnel lens, a light pipe, or a waveguide. Contact lens 10 may include battery 20 and sensor 22 . Contact lens 10 may comprise a flex printed circuit board (PCB) 24 on which a processor may be mounted. The processor may be mounted on PCB 24 and coupled to sensor 22 and multiple light sources 30 . Soft contact lens 10 may also include wireless communication circuitry and one or more antennas 41 for electronic communication and for inductive charging of battery 20 of contact lens 10 . Although referring to battery 20, contact lens 10 may comprise any suitable energy storage device.

Projection unit 12 may be configured to provide a defocused image to the peripheral portion of the retina, as described herein, and may include a light source and projection optics. In some embodiments, one or more projection optics are configured with a light source to stimulate a change in choroidal thickness, such as an increase or decrease in choroidal thickness, to project the defocused image to the light source. , project onto the peripheral retina away from the central visual field, including the macula. The one or more projection units 12 are adapted to stimulate the retina without degrading central vision and corresponding images formed on one or more of the foveal or macular regions of the retina. can be configured to In some embodiments, the one or more projection optics do not reduce the image, forming a characteristic of vision correction optics prescribed to correct the wearer's refractive error. This configuration can allow the wearer to have good vision while receiving therapy from defocused images as described herein.

In some embodiments, the light source from projection unit 12 is collimated and focused by one or more projection optics, as described herein. The function of the light source and projection optics is to substantially collimate the light emitted by the light source and place it in front of or behind the retina to provide adequate defocusing and stimulate changes in choroidal thickness. It is designed to focus on a focal point. For myopic defocusing, since the focused image is, for example, about 2.0D to 5.0D, such as 2.0D to 4.0D, or preferably 2.5D to 3.5D myopic At the same time, it can appear approximately 1.5 mm to 2.5 mm in front of the peripheral retina. For hyperopic defocusing, the focused image is, for example, about -2.0D to -5.0D, such as -2.0D to -4.0D, or preferably -2.5D to -3.0D. Being 5D hyperopic, it can appear about 1.5 mm to 2.5 mm behind the peripheral retina.

According to some embodiments, the soft contact lens 10 comprises a projection unit, which includes projection optics and a microdisplay as light source. The microdisplay may comprise an array of OLEDs (organic light emitting diodes) or microLEDs. The light emitted by these displays may be Lambertian. In some embodiments, the microdisplay is optically coupled to a micro-optic array that substantially collimates and focuses light emitted from the microdisplay. A microdisplay may comprise one or more small pixels. In some embodiments, the microdisplay forms an elongated array of pixels characterized by a pixel size and a pixel pitch, wherein both the pixel size and pixel pitch correspond to the fill factor of the microdisplay. do. As described herein, pixels may each have a size within the range of about 2 microns to about 100 microns, and pixel pitch may range, for example, from 10 microns to 1.0 mm. . The corresponding filling factor can range from 0.1% to 10% or even more. In some embodiments where real-world viewing is desired, a smaller fill factor blocks less light from the real-world environment and provides a higher level of comfort and vision. Alternatively, or in combination, a higher fill factor may improve the overall brightness of the stimulus and may be well suited for applications that do not rely on real-world viewing and all-around vision. In some embodiments, the pixel array is optically coupled with the micro-optic array to substantially collimate and focus the light from the pixels.

The images produced by these displays may be defocused and placed symmetrically within the four quadrants of the visual field or eye (e.g., inferior nasal, superior nasal, inferior temple, and superior temple). . The microdisplay can be positioned away from the optical center of the lens by a distance in the range of 1.5 mm to 4.0 mm, preferably 2.5 mm to 3.5 mm. The central optic of the contact lens can be selected to provide normal vision to the wearer and may have a diameter within the range 3.0-5.0 mm. Each microdisplay, in some embodiments, may be circular, rectangular, or arc-shaped and within the range of 0.01 mm ² to 8.0 mm ² , such as 0.04 mm ² to 8.0 mm ² , for example in the range 1 mm ² to 8 mm ² or preferably in the range 1.0 mm ² to 4.0 mm ² .

The microdisplay is coupled to and supported with the body of corrective optics, such as, for example, contact lenses or spectacle lenses, augmented reality (“AR”) headsets, or virtual reality (“VR”) headsets. can In some embodiments, the microdisplay is coupled to and supported with one or more of an intraocular lens, a corneal prosthesis, a corneal onlay, or a corneal inlay. The optical configurations described herein with reference to contact lenses may also be used in conjunction with one or more of, for example, intraocular lenses, corneal prostheses, corneal onlays, or corneal inlays. can be done.

In some embodiments, the microdisplay and microoptic array, as described herein, direct the light beam to the pupil of the eye in an orientation that forms a defocused image at the desired location on the retina. They are mounted immediately adjacent to each other on the same correction optics, separated by a fixed distance for projection. In some embodiments, the one or more projection optics are mounted on or within the one or more correction optics such that light rays from the projection optics are refracted through the correction optics. be done. Corrective optics are used to provide clear vision so that the micro-optic array can provide the desired amount of additional power, which can be + or -, depending on the magnitude and sign of defocusing desired. refracts the rays from the projection optics so that they are convergent or divergent, as is useful for Microdisplays may be, for example, monochrome or polychromatic.

In some embodiments, the projected defocused image is one or more of an LCD screen, an OLED (organic light emitting diode), TOLED, AMOLED, PMOLED, or QLED driven screen. It can be provided by a microdisplay, comprising a screen, comprising a thing. The screen may appear to the subject at a distance of at least 6 meters or more, for example.

FIG. 3 shows the mechanical integration of the functions of the components of a retinal stimulation device such as contact lens 10 as in FIG. Although reference is made to mechanical integration with contact lenses, similar integrations can also be implemented with any vision device as described herein. These components can be supported using PCB 24 . For example, a power source such as battery 20 may be mounted on PCB 24 and coupled to other components to provide power supply function 21 . A sensor 22 may be configured to provide an activation function 23 . Sensor 22 may be coupled to a processor mounted on PCB 24 to provide control functions 25 for contact lens 10 . Control function 25 may comprise light intensity setting 27 and light switch 29 . The processor is configured to detect signals from sensor 22 corresponding to, for example, increased intensity, decreased intensity, or on/off signals from sensor 22, along with encoded sequences of signals from sensor 22. can The processor is coupled to the light projection unit 12, which may comprise a light source 30 for providing a projection function 31 and an optical system 32. For example, the processor may be coupled to multiple light sources 30 and control each of the light sources 30 in response to user input to the sensor 22 .

The retinal stimulation device may include global positioning system (GPS) circuitry for determining the wearer's location and accelerometers for measuring body movement, such as head movement. The retinal stimulation device may comprise a processor coupled to one or more of the GPS or accelerometer to receive and store the measured data. The retinal stimulation device uses a wireless communication network, such as Bluetooth® or WiFi, or a wired communication network, such as, to transmit data from the device to a remote server, such as a cloud-based data storage system. A communication network such as USB may be provided. This transmission of data to a remote server can allow the wearer's therapy and compliance to be monitored remotely. In some embodiments, the processor comprises a graphics processing unit (GPU). A GPU, as described herein, can be used to efficiently and rapidly process content from the web to utilize this content in forming stimuli.

Methods and apparatus for retinal stimulation as described herein can be configured in many ways, with one or more attributes to prompt a user to receive therapy. good too. For example, retinal stimulation as described herein can be combined with a game display to prompt the user to wear a therapeutic device. In some embodiments, the retinal stimulation can be combined with another stimulus, such as a glyph, eg, a smiley face, to prompt the user to wear the device for therapy. Components of the system may communicate with or receive information from games or other stimuli and use the games or stimuli to facilitate retinal stimulation.

Referring to FIG. 4A, in some embodiments, optical arrangement 32 collects light emitted by microdisplay 12 to form an off-center retinal image, as shown in FIG. It comprises a plurality of mirrors configured to direct the beam to the pupil of eye 11 . The mirrors may substantially collimate the light beam or direct the light beam toward the retina 33 with suitable binocular separation movements to focus the light beam on the retina 33 .

Although the optical configurations shown in FIGS. 4A and 4B refer to lenses such as contact lenses, similar optical configurations include projectors, ophthalmic equipment, TV screens, computer screens, handheld devices such as smartphones, spectacle lenses, ocular displays, head Wearable devices such as part-mounted displays, AR displays, VR displays, lenses of one or more of goggles, contact lenses, corneal onlays, corneal inlays, corneal prostheses, or intraocular lenses can. Also, reference is made to myopic defocusing, but defocusing is defined as, for example, hyperopic defocusing, or images focused on the retina, or correction of refractive error, as described herein. There may be other defocusing for .

The mirror assembly shown in FIG. 4A achieves a depth of focus that is less than 1D, with an applied defocus of 2.0-4.0D for a defined decentration (eg, in the range of 20-30 degrees inner) to be clearly perceived by the peripheral retina 33 .

As shown in FIGS. 5A and 5B, another embodiment comprises optics 32 comprising a converging or collimating lens in optical communication with light source 30 . In this configuration, lens 34, which may comprise a single lens, is used to substantially collimate the light output from the stimulus source and direct it through a lens, such as contact lens 10, to cornea 37. . While reference is made to contact lenses, lenses also include projectors, ophthalmic equipment, TV screens, computer screens, handheld devices such as smartphones, spectacle lenses, eyepiece displays, head-mounted displays, VR displays, and wearable devices such as AR displays; It may comprise lenses of one or more of goggles, contact lenses, corneal onlays, corneal inlays, corneal prostheses, or intraocular lenses.

The effectiveness of collimating lens 34 depends on its refractive index and should be high enough to create a substantial difference in refractive index between the lens material and the material of contact lens 10, which serves as the substrate. is. In this example, the refractive index of the built-in lens 34 is assumed to be 2.02 (eg, the refractive index of lanthanum fluorosilicate glass LaSF ₅ ), although other materials may also be used. .

Another embodiment comprises a light pipe 36 as shown in FIGS. 6A and 6B. Light pipe 36 provides an increased optical path length to reduce image magnification and retinal image size in order to provide higher spatial frequencies to images projected onto the retina, according to some embodiments. can let

Reference is made to the light pipe 36 on the cornea 37 as would occur with a contact lens, but the lens in combination with the light pipe 36 can be used in projectors, ophthalmic equipment, TV screens, computer screens, handheld devices such as smartphones, Wearable devices such as spectacle lenses, eyepiece displays, head-mounted displays, VR displays, AR displays, goggles, contact lenses, corneal onlays, corneal inlays, corneal prostheses, or intraocular lenses, or more A lens may be provided.

Numerous other optical configurations with point sources, including the use of microlens arrays, the use of diffractive optics to use thinner lenses, the generation of multiple retinal images using a single point source and an optical processing unit. may be used. In all cases, the three properties listed above may be used as metrics to assess the suitability of a particular design.

Figures 7A and 7B depict spectacles 70 for the treatment of refractive errors of the eye, such as spherical and astigmatic refractive errors. Although reference is made to spectacles, a light source can be provided on any vision device described herein to treat astigmatism. In some embodiments, the spectacles comprise a first axis of astigmatism 80 and a second axis of astigmatism 81 . A plurality of light sources are arranged to treat astigmatism according to the astigmatism axis of the eye. The plurality of light sources may comprise any suitable light sources as described herein, such as, for example, microdisplays or projection units. In some embodiments, the light source is directed along different axes to facilitate different changes in choroidal and scleral tissue corresponding to different changes in axial length, as described herein. configured to provide different amounts of illumination. The lens may comprise an optical zone with optical properties, eg, refractive properties, configured to correct astigmatic ametropia according to first axis 80 and second axis 81 . This refractive treatment of astigmatism can be combined with retinal stimulation as described herein.

Glasses 70 may comprise one or more components of commercially available augmented reality glasses. Glasses 70 may include one or more displays 72 for retinal stimulation. Eyepiece display 72 may be mounted on lens 74 . Lens 74 may be a spectacle lens supported by spectacle frame 76 . Lens 74 may be a correcting or non-correcting lens. Lens 74 may be a flat lens, a spherical correction lens, an astigmatism correction lens, or a prism correction lens. In some embodiments, the ocular display is positioned away from the optical zone to provide clear central vision. An optical axis may extend from the patient's point of gaze, through the lens 74, along the line of sight to the fovea of the eye. In some embodiments, glasses 70 include eye trackers suitable for incorporation according to the present disclosure. Eyepiece display 72 can be programmed to selectively activate pixels 94 to provide peripheral stimulation to the retina as described herein. In some embodiments, a layer of plastic substrate supporting microlenses is attached to the microdisplay to produce the desired level of defocusing and stimulation in the retina. The selectively activatable pixels comprise groups of pixels, e.g., a first group of pixels 94A, a second group of pixels 94B, a third group of pixels 94C, and a fourth group of pixels 94D. well, both of which can be selectively activated. The groups of pixels can be arranged to provide the appropriate decentration relative to the patient's line of sight to provide peripheral retinal stimulation, as described herein.

In some embodiments, eyepiece display 72 comprises a combination of microdisplays and micro-optics. In some embodiments, the micro-optics are configured to collect, substantially collimate, and focus light rays emanating from the microdisplay. In some embodiments, the micro-optics are configured to form an image in front of or behind the retina as described herein. In some embodiments, the distance of the ocular display from the eye's entrance pupil is in the range of about 10 mm to about 30 mm, eg, about 15 mm. A microdisplay can be mounted on a transparent substrate, such as the front or back surface of the lenses 74 of the glasses 70 . When the microdisplay is placed on the front surface of lens 74 , the focus of the microdisplay can be affected by a cylindrical correction on the rear surface of lens 74 .

In some embodiments, the focal point of a pixel within the microdisplay varies based on its location on lens 74, and refractive correction may be provided by the lens within that area. In some embodiments, the pixel focus may be fixed. In some embodiments, the focal point of the pixel may vary based on the sensed position of the cornea to account for refraction of the cornea and lens of the eye. In some embodiments, the pixels are defocused to create a defocused spot of approximately 1 mm diameter on the retina.

The light emitted by the pixels 94 in the microdisplays of the eyepiece display is substantially collimated and/or focused before being directed to the pupil of the eye. can be done. In some embodiments, the microlens array is aligned with the pixels of the ocular display such that light rays from the ocular display can enter the pupil and form an image in front of or behind the retina. In some embodiments, the width of the eyepiece display corresponds to the patient's field of view. In some embodiments, the area of the eyepiece display may be substantially similar to the area of the lenses 74 of the glasses 70 . In some embodiments, the device provides intact central vision such that the wearer's quality of life and vision is not adversely affected. In some embodiments, central vision comprises a visual field of +/−12.5 degrees covering the macula, while foveal vision used for fixation is +/−2.0 degrees field of view. In some embodiments, the defocused image is projected onto the outer portion of the retina toward the periphery of the retina, e.g. can be in the range of degrees to 30 degrees. In some embodiments, microdisplay 72 does not block the central visual field. In some embodiments, pixels 94 do not block the central visual field.

In some embodiments, the microdisplay and optics are designed to project light onto the outer region of the retina far enough away from the fovea that the illumination remains substantially fixed even with eye movement. Configured. In some embodiments, the point of gaze is monitored, the desired location of the pixels to be activated on the microdisplay, the image is projected to the desired location on the retina, and sustained stimulation at the same retinal location is performed. is determined, for example, by computation using a processor, so as to allow In some embodiments, the gaze point on the spectacle plane or the microdisplay plane is calculated by monitoring horizontal, vertical, and torsional displacement of the eye relative to the first eye position.

The gaze point can be determined in many ways, for example using an eye position sensor such as a magnetic sensor or an optical sensor. In some embodiments, searcher coils built into the spectacle frame are used to track eye movements. A spectacle frame embedded in a coil, such as one or more of a coil on a contact lens, a coil implanted in the eye, a magnetic material on the contact lens, or a magnetic material implanted in the eye. , can be coupled to a magnetic structure placed on the eye. In some embodiments, the sensor comprises an optical sensor, such as a position sensitive detector or an array sensor for optically measuring eye position. The optical sensor is configured in many ways to measure the position of the eye, e.g., the position of one or more of the corneal reflection from the light source, the pupil, the limbus, or the sclera. can be configured to measure The spectacle frame may support additional light sources to illuminate the eye and, for example, produce corneal reflections. Data from the sensor can provide the location of the coaxial visual corneal light reflection (“CSCLR”), and thus the direction of the visual axis and the location of the fovea. In some embodiments, the processor uses the eye position sensor to adjust optics, such as pixels in the microdisplay, to reduce movement of the stimulated location of the retina in response to eye movement. may be configured. In some embodiments, the target location of the peripheral image is calculated from the location of the fovea based on information from the eye position sensor, and real-time ray tracing calculations are performed on the pixels to be activated within the microdisplay. provide a location. The time to selectively switch to the second plurality of pixels in response to eye movement can be less than 100 milliseconds, such as less than 20 milliseconds.

In some embodiments, the location of the pixels within the microdisplay that are to be activated to form an image outward toward the periphery of the retina is determined by the optics of the spectacle optics, as it is the gaze point in the primary line of sight. Referenced from the center. In some embodiments, the location of the point of regard is calculated by considering the eye movement relative to the position of the eye in the primary line of sight and calculating the locations of the pixels to be activated with reference to the new point of regard. For example, FIG. 7A shows active pixels 94 when the patient is looking horizontally and straight ahead, the so-called primary line of sight, while FIG. 7B shows active pixels 94 when the patient is looking to the upper left. In such cases, the shape of the array of pixels may be the same but translated to the upper left, or the shape of the array may change. In some embodiments, multiple light sources, e.g., active pixels 94, are aligned along a first astigmatism axis 80 and a second astigmatism axis 81 relative to the eye when these axes are translated, e.g. is configured to vary so as to maintain the alignment of This translation and alignment is provided with processor instructions configured to selectively activate pixels according to eye movement and first and second astigmatism axes 80 and 81. can

In some embodiments, the device is binocular and includes a microdisplay and optics for each eye of the user. The microdisplay is optically coupled with one or more micro-optical components designed to substantially collimate the illumination produced by the pixels of the microdisplay and converge before entering the pupil. can

In some embodiments, the display 72 typically has an eye movement of +/-15 degrees laterally and +10 to -20 degrees vertically, including downward gaze when reading or viewing nearby objects. mounted on the outside of the spectacle lens so that the microdisplay can continue to provide peripheral retinal stimulation and the eyepiece display can provide a field of view of +/- 40 degrees or more, with respect to the normal range of Matched with spectacle lens optics. In some embodiments, the light from the microdisplay is transmitted through the spectacle lens optics to provide the wearer's refractive correction.

In some embodiments, the optical system is configured to form an image in front of the retina and comprises a single microlens (lenslet), multiple microlenses (lenslet array), a Gabor lens, a microprism, or With one or more of compound lenses, such as micromirrors, or combinations thereof. In some embodiments, the light baffles and micromirrors reduce stray light and light escape from the front side of the display so that the amount of light not captured by the micro-optics is substantially reduced, e.g. Arranged to ensure that it is minimized.

In some embodiments, a pixel fill factor of less than 10% (0.1) is sufficiently sparse to provide a clear view of the foveal and macular images. In some embodiments, the fill factor is in the range of 0.01-0.3 and can be in the range of 0.05-0.20. For example, an array of pixels with a pixel size of 5 microns and a pixel pitch of 20 microns leads to a fill factor of 0.06. A low fill factor can also reduce the complexity of the manufacturing process and reduce the cost of such micro-optic displays.

In some embodiments, the micro-optic array is directed at the wearer's pupil in the primary line of sight, so that light from a single or multiple pixels 94 can be collected, collimated, and focused on the display. is designed to be optically matched with The density of these micro-optical elements can control the overall visibility of the ocular display. In some embodiments, the micro-optics are designed such that the overall light transmission through the ocular display is acceptable to the wearer and will allow the patient to view the object. It has a low fill factor (preferably less than or equal to 0.1).

In some embodiments, the device can be switched from one index of refraction to another, or from one polarization to another. An optical component comprises a switchable micro-optical array that can be switched between a flat (no refractive power) state and an activated state. In some embodiments, the micro-optic array does not scatter light or distort real-world images when not activated.

In some embodiments, the location of the pixels within the microdisplay that are to be activated to form the outer image toward the periphery of the retina is determined by the optics of the spectacle optics, as it is the gaze point in the primary line of sight. Referenced from the center. In some embodiments, the point-of-regard location is calculated by calculating the locations of pixels to be activated with reference to the new point-of-regard, taking into account the eye movement relative to the eye position in the primary line of sight. .

In some embodiments, multiple pixels are activated to form a light source that is imaged by the micro-optics. The optical design of the micro-optics and its separation from the microdisplay depends on the focal length of the image delivery system, the image magnification of the image projected onto the retina, and diffraction as measured by the Airy disk diameter of the optical delivery system. It can be configured to provide the resulting blur.

Studies related to this disclosure show that the retina is sensitive to the sign of defocusing (in addition to spherical defocusing), including longitudinal chromatic aberration (LCA), higher order spherical aberration, astigmatism, etc. suggest that we perceive changes in image blur caused by higher order aberrations present in the blurred image. Based on the teachings provided herein, those skilled in the art will recognize myopic blur from hyperopic blur when the depth of focus of the device is greater than or approximately equal to the defocus magnitude. Experiments can be done to determine if it does. A device as described herein, for example, can be suitably configured to provide the right amount of defocusing in the right place.

The device provides limited image resolution and depth of focus in relation to the appropriate image magnification, the magnitude of myopic defocusing applied, diffraction, and imaging as a function of defocusing magnitude. It can be configured to provide a rate of change of blur or image sharpness gradient.

In some embodiments, the ocular display is configured to provide a clear, substantially undistorted view of the foveal and macular images for comfortable viewing. In some embodiments, the field of view of the central image is at least +/−12 degrees, and can be more to account for differences in interpupillary distance (IPD) of different wearers. Real image quality and viewing can be provided by reducing the fill factor of light emitting pixels in the microdisplay while the substantially transparent eyepiece display remains transparent. In some embodiments, a fill factor of less than 10% (0.1) is sufficiently sparse to provide a clear view of the foveal and macular images. In some embodiments, the fill factor is in the range of 0.01-0.3 and can be in the range of 0.05-0.20. For example, an array of pixels with a pixel size of 5 microns and a pixel pitch of 20 microns would lead to a fill factor of 0.06. A low fill factor can also reduce the complexity of the manufacturing process and reduce the cost of such micro-optic displays.

In some embodiments, the micro-optic array is integrated with the display such that light from single or multiple pixels can be collected, collimated, and focused to be directed at the wearer's pupil in the primary line of sight. Designed to be optically matched. The population density of these micro-optical elements can control the overall visibility of the ocular display. In some embodiments, the micro-optics have a low fill factor (preferably less than or equal to 0.1) so that overall light transmission through the ocular display would be acceptable to the wearer. have

In some embodiments, the device can be switched from one index of refraction to another, or from one polarization to another. An optical component comprises a switchable micro-optical array that can be switched between a flat (no refractive power) state and an activated state. In some embodiments, the micro-optic array does not scatter light or distort real-world images when not activated.

The systems and devices discussed above may be used, for example, in the treatment of astigmatism independently of or in combination with treatments for myopia or hyperopia. FIG. 8 shows a method 800 for treating refractive error in one or both eyes of a patient. At step 810, the refractive error of the patient's eye is determined.

Astigmatism of an eye can be determined in many ways. Preferred approaches for determining astigmatism in the eye are manifest refraction with ophthalmometer, autorefraction, rescopy, corneal topography, wavefront measurements, Scheimpflug imaging, optical coherence tomography, HartmannShack wavefront aberration. measurement, and one or more of other approaches for measuring astigmatism as known to those skilled in the art.

If astigmatism anomalies are found in step 810, then in step 820 the patient's eye astigmatism anomalies are corrected. If a spherical anomaly is found in step 810, then in step 830 the spherical anomaly of the patient's eye is corrected. In some embodiments, correction of anomalies in steps 820 and 830 may occur in parallel or serially. For example, in some embodiments, correction of astigmatism aberrations in step 820 may occur before correction of spherical aberrations in step 830 . In some embodiments, the treatment may be reversed, and correction of spherical aberration in step 830 may occur before correction of astigmatism aberration in step 820 . Still, in other embodiments, treating the spherical aberration in step 830 and treating the astigmatic aberration in step 820 may occur at the same time, eg, simultaneously or in parallel.

More specifically, at step 810 a refraction assessment may be performed. The refraction assessment may be an automated assessment performed by an automatic refractometer, or the assessment may be a manual assessment using an ophthalmometer. In either case, the result of the assessment is a determination of the refractive properties of the patient's eye. Properties include spherical correction for nearsightedness or farsightedness, cylinder correction for astigmatism, and orientation of the axis of the cylinder to correct astigmatism. In some embodiments, at step 810 a refraction prescription or the results of a previously performed refraction assessment may be received.

Table 1 shows exemplary refraction assessment results for a patient, according to some embodiments. Assessment indicates that the patient is 1 diopter (“D”) myopic with −2 diopters of astigmatism. In cylindrical correction for astigmatism, a cylindrical lens is used with a zero power axis extending along the axis of the cylinder, the power of the cylindrical lens being oriented at 90 degrees to the axis of the cylinder. . The axis of the cylinder is measured counterclockwise from horizontal in both eyes, as is known to those skilled in the art of optometry or ophthalmology.

With the exemplary axis of the -2D correction cylinder aligned with the cylinder axis at 90 degrees, the refractive power of the cylinder is 180 degrees along the meridian to correct the steep meridian of the cornea oriented at 180 degrees. located in degrees. In this example, the cornea is more steeply curved along the medial-lateral direction (steeper meridians) and less steeply curved or flatter along the superior-inferior direction (flatter meridians).

Reference is made to a cylinder with a minus "-" power, but the refraction can also be provided with a plus "+" cylinder power, as will be apparent to those skilled in the art. Using the example refraction above, the refraction with positive cylindrical notation would be -3 (sphere) + 2 (cylinder) x 180 (degrees).

Although referring to the use of refractive error, the corneal topography system determines the astigmatism axis of the eye and uses the corneal astigmatism of the eye to provide stimulus to the retina relative to the corneal astigmatism axis of the eye. It can be used to determine aberrations and the corresponding steeper and flatter meridians of the cornea.

Although treatment is referred to in terms of the astigmatism axis, the astigmatism axis may comprise a flat axis or a steeper axis. In some embodiments, the astigmatism axis is accompanied by the cylinder axis corresponding to positive cylinder notation. Alternatively, the astigmatism axis accompanies the cylinder axis, corresponding to negative cylinder notation. Also, the axis of the cylinder may correspond to the curved meridian of the cylindrical lens, such as the flat meridian of the cylindrical lens or the curved meridian perpendicular to the flat meridian.

Once the patient's refractive error is known, the process proceeds to one or both of steps 820 and 830, and the orientation of one or more stimuli relative to the axis may be determined.

At step 820, astigmatism aberrations may be corrected by stimulating changes in the choroidal thickness of the eye along the meridians. In the examples provided in Table 1, the patient's eye can be stimulated relative to the patient's axis of astigmatism. In some embodiments, to correct for cylindrical refractive error, optical stimulation as described herein is provided on both sides of the 90 degree axis and compared to the choroidal thickness of the retina of the eye at the unstimulated location. to stimulate increased choroidal thickness in the retina of the eye on both sides of the 90 degree axis. Changes in the choroidal thickness of the eye can result in decreased scleral growth in stimulated locations compared to unstimulated or less stimulated locations. In some embodiments, the stimulus, such as a defocused image, is projected onto the outer portion of the retina, towards the periphery of the retina, within a range of eccentricity of, for example, 15 degrees to 40 degrees relative to the fovea. and can be within 20-30 degrees eccentricity with respect to the fovea.

The increased choroidal thickness and associated reduction in scleral growth can be provided by any suitable approach. In some embodiments, a differential change in choroidal thickness provides a differential change in scleral length, which in turn provides a change in astigmatism of the eye. Changes in choroidal thickness of the eye are stimulated (or more) compared to unstimulated (or less stimulated) locations to provide different scleral growth corresponding to different astigmatic meridians of the cornea. stimulated), resulting in reduced scleral growth.

The stimulation location on the retina and associated changes in the choroid and retina can be referenced to the steeper and flatter meridians of the cornea. The location of the eye corresponding to the steeper meridian may comprise the location of the eye corresponding to the plane defined by the steeper meridian of the cornea extending from the cornea through the sclera and retina of the eye. The location of the eye corresponding to the flatter meridian of the cornea may comprise the location of the eye corresponding to the plane defined by the flatter meridian of the cornea extending from the cornea through the sclera and retina of the eye.

Without being bound by any particular theory, differential changes in choroidal thickness and scleral length to treat astigmatism can also be provided by alternative mechanisms. In some embodiments, the stimulation reduces eye growth at locations corresponding to steeper meridians and reduces astigmatism by reducing scleral growth at locations corresponding to steeper meridians. In order to allow the cornea to be delivered to a location corresponding to the steeper meridian of the cornea (the steeper meridian stimulus "SMS"). In an alternative embodiment, the stimulation reduces eye growth at locations corresponding to flatter meridians and reduces astigmatism by reducing scleral growth at locations corresponding to flatter meridians. Secondly, it is provided at a location corresponding to the flatter meridian of the cornea (flattened meridian stimulus "FMS"). Using embodiments of the FMS approach, increased scleral growth along the steeper meridians flattens the steeper meridians and reduces tension on the cornea to reduce astigmatism. , relaxes the cornea along the steeper meridians. One skilled in the art can conduct experimentation to determine which of these alternative approaches provides better results without undue experimentation, for example by conducting clinical trials according to the present disclosure. It can be carried out.

In some embodiments, the stimulus is configured to provide a differential change in axial length of the eye to reduce astigmatism. In some SMS embodiments, to correct for cylindrical refractive error, the optical stimulus provides a differential change in the axial length of the eye, corresponding to the steep meridians of the cornea to reduce astigmatism. , provided at locations eccentric to the fovea, stimulated increased choroidal thickness, and increased strength at locations corresponding to steep meridians compared to scleral growth at locations corresponding to flatter meridians. Reduces film growth. In some embodiments, the stimulus is configured to provide a differential change in axial length of the eye to reduce astigmatism. In some FMS embodiments, the optical stimulus provides a differential change in the axial length of the eye to correct for cylindrical refractive error, e.g., to reduce astigmatism as the cornea relaxes. In particular, provided at locations eccentric to the fovea corresponding to flatter meridians of the cornea, stimulating increased choroidal thickness, compared to scleral growth at locations corresponding to steeper meridians, Reduces scleral growth in locations corresponding to flatter meridians.

For astigmatism correction, the focal point along the astigmatism meridian is about 1.5-2.5 mm behind the peripheral retina (about 2.0D-5.0D, such as 2.0D-4.0D, or preferably, eg, 2.5D to 3.5D) to about 1.5-2.5 mm in front of the peripheral retina (about -2.0D to -5.0D, eg, -2.0D to -4. 0D, or preferably, for example, from -2.5D to -3.5D). In some embodiments, the stimulus is a pair of 2.0-5.0D myopic defocused images at the retinal periphery along the astigmatic meridian while preserving central vision. In some embodiments, central vision comprises a visual field of +/-12.5 degrees covering the macula, while foveal vision used for fixation is +/-2.0 degrees. have a field of view.

While in the examples discussed above the defocused image is provided defocused, corresponding to the patient's astigmatic refractive error, in some embodiments the defocused image is the patient's refractive error. Anomalies may be exceeded. For example, a -3 diopter defocused image may be used to stimulate a patient's retina with -2 diopter astigmatism.

The devices and systems disclosed herein may be used to provide desired stimulation. The device is configured to provide one or more stimuli along the astigmatic meridian onto the retina, which falls outside the fovea, eg, outside the macula. The stimulation can be configured to encourage a change in one or more of axial length or choroidal thickness of the eye. The stimuli may comprise static images or may be dynamic, eg, in the range of 10 Hz to 200 Hz, eg, with a certain refresh rate. The light may comprise monochromatic or polychromatic light. One or more images can be constructed in many ways with image structures corresponding to the information or content of the image associated with spatial frequencies. In some embodiments, the one or more images have a spatial frequency in the range of, for example, 1 cycle/degree to 180 cycles/degree and a contrast in the range of 99.9% to 2.5%. Prepare. The projected image can be projected onto the retina with an eccentricity associated with the fovea, which can be in the range of 5 degrees to 40 degrees, for example. The projected image may cover a portion of the retina within a defined range of decentration along the astigmatic meridian, e.g. It may be an annular sector or an arc over a minor arc length mirrored about the degree meridian. The arc length may be less than 90 degrees, less than 60 degrees, less than 45 degrees, less than 30 degrees, less than 15 degrees, less than 10 degrees, less than 5 degrees. Alternatively, or in combination, the arc length may be, for example, within the range of 1 degree to 45 degrees or within the range of 10 degrees to 35 degrees. Although referring to arc length, stimuli can be configured in many ways.

In some embodiments, a single light source or group of light sources illuminates the retina with a spot or multiple spots in relation to the astigmatic meridian, e.g., along the astigmatic meridian; may be stimulated by For example, a single light source may provide two diopters of myopic defocused spots on either side of the steeper meridian or on the flatter meridian, depending on the desired change in astigmatism. . A spot may be circular, with a diameter, as discussed herein. In some embodiments, the stimulus is provided by light emitted by a microdisplay, as discussed herein. Retinal stimulation may be applied using an optical projection system or projection unit as described herein.

In some embodiments, using an image or multiple images in which multiple light sources, such as pixels of a microdisplay, correspond to steeper meridians or flatter meridians, as discussed herein, The retina may be illuminated and thereby stimulated. For example, a single microdisplay may provide a 2 diopter myopic defocused image on either side of a flatter meridian. Alternatively, a single microdisplay may provide a 2 diopter myopic defocused image on either side of the steeper meridian. The image may be circular, or other shapes as discussed herein. Retinal stimulation may be applied using an optical projection system or projection unit.

Stimulation may be continuous or periodic or aperiodic. When periodic, stimulation may last for durations ranging from 1 second to 24 hours. Stimulation may be applied while the subject is awake or asleep and combinations thereof.

Stimulation of the patient's eye to correct for astigmatism may continue until the patient's eye's cylindrical abnormality is corrected. In the above example, astigmatism correction may be applied to reduce the -2 diopter astigmatism to zero.

In some embodiments, after the patient's eye has been corrected for astigmatism, process 800 may proceed to step 830, where the spherical patient's eye is corrected for refractive error. In the example shown in Table 1, the spherical refractive error of the patient's eye is -1 diopters. To correct this spherical refractive error, light from the light source of the projection unit is focused by one or more projection optics as described herein.

At step 830, the spherical aberration may be corrected by stimulating a change in the axial length of the eye eccentric to the fovea. In some embodiments, stimuli are provided through both meridians of the cornea to correct for spherical refractive error, resulting in growth of choroidal thickness of the eye and axial length of the eye corresponding to changes in spherical refractive error. Inspire change. In some embodiments, the stimulus, such as a defocused image, is directed towards the outer portion of the retina, e.g. projected and can be in the range of 20-30 degrees.

The devices and systems disclosed herein may be used to provide desired stimulation. The device is configured to provide stimulation on the retina eccentric to the fovea. A spherical stimulus can be configured to encourage changes in the axial length or choroidal thickness of the eye. The stimuli may comprise static stimuli or may be dynamic, eg, with refresh rates as discussed herein. The image light may comprise monochromatic or polychromatic light. One or more images can be constructed in many ways, with image structures corresponding to information or content of the image associated with spatial frequencies. In some embodiments, the one or more images have a spatial frequency in the range of, for example, 1 cycle/degree to 180 cycles/degree and a contrast in the range of 99.9% to 2.5%. Prepare. The projected image can be projected onto the retina with an eccentricity associated with the fovea, which can be in the range of 5 degrees to 40 degrees, for example. The projected image may cover a portion of the retina within a defined range of eccentricity, e.g. , or an annular shape extending within a range of 20-30 degrees of eccentricity.

Stimulation of the patient's eye to correct spherical refractive error may continue until the patient's eye's cylindrical error is corrected. In the above example, a spherical correction may be applied to reduce the -1 diopter spherical refraction to about zero.

Although the above process is described as the action of step 820 occurring before the action of step 830 , in some embodiments the action of step 830 may occur before the action of step 820 . For example, the refractive error of a spherical eye may be corrected from -1 to about 0 before the astigmatic refractive error is corrected to -2 to about 0. In some embodiments, the actions of steps 820 and 830 may alternate. For example, a partial astigmatism correction of -2 to -1 is performed according to step 820, followed by a partial spherical correction of -1 to -0.5, followed by a second partial correction of -1 to 0. A spatial astigmatism correction may follow, followed by a second partial spherical correction of -0.5 to 0. Although partial correction is described in four alternating steps, any number of alternating steps may be used to correct the patient's refractive error.

In some embodiments, steps 820 and 830 may be combined and the spherical and astigmatic refractive error of the eye may be corrected simultaneously. For example, the eye may be stimulated about a steep meridian along which the patient's astigmatism occurs, while at the same time the eye may be stimulated through a flatter meridian centered about and eccentric to the fovea. .

In some embodiments, the stimulus provided to the retina for simultaneous correction of spherical and astigmatic refractive error may differ from that provided during separate correction steps, while the stimulus provided to the retina may differ from that provided during the separate correction steps. The intensity is the same for both regions. For example, in some embodiments of simultaneous correction, the refractive correction may be additive to the in-area spherical correction stimulated for astigmatism correction.

In some embodiments, spherical and astigmatic refractive errors may be corrected by varying the intensity of the light or image while keeping the amount of defocus the same. For example, a stimulus, such as an image, is provided to the retina at a defocus of −2 diopters decentered to the fovea, centered within the peripheral area around the fovea, and the growth of the choroidal thickness of the eye and the axis of the eye. A change in directional length may be stimulated. However, light may be provided at two or more intensities or at two or more different intervals to treat spherical and astigmatic aberrations simultaneously. For example, the intensity of the stimulating light or image to treat an astigmatic region may be provided at a first intensity, while the intensity of the stimulating light or image within the area to treat only spherical aberration is It may be a second intensity. The first intensity overwhelms the second intensity, and at a rate lower than the rate of scleral growth away from the location corresponding to the flatter meridian, along the steeper meridian of astigmatism. may stimulate changes in choroidal thickness growth and scleral growth.

In some embodiments, the duration of stimulation may be varied. For example, stimulation may be applied on a daily or other time basis. In such embodiments, patients with different amounts of astigmatism and spherical refractive error may have different time-based stimuli to treat the abnormality. For example, a patient with spherical and cylindrical refractive error in an eye may have astigmatic stimulation four times a day and spherical stimulation twice a day.

In some embodiments, the simultaneous treatment of astigmatism and spherical eye refractive error may vary in one or more of intensity, defocusing, and periodic stimulation. For example, the spherical ametropia correction may be a defocused image or light of −1 diopters at a first intensity decentered to the fovea in an area not stimulated by a refractive stimulus, while astigmatism The ametropia correction may be -3 diopters along the steeper meridian at the second intensity. The first intensity may be greater than or less than the second intensity. The difference in intensity may be varied based on the amount of defocusing. For example, less defocusing may be used in combination with higher light intensity and more time-based cyclic therapy, or more defocusing may be used in combination with lower light intensity and less May be used in combination with time-based cyclic therapy.

9A and 9B correspond to the patient's astigmatism meridians and are projected onto the retina at locations away from the central visual field, e.g., away from the macula, to stimulate changes in choroidal thickness. 1 depicts a contact lens 10 configured to provide a stimulus, such as a focused image, to treat astigmatism. Although reference is made to a contact lens, lens 10 may comprise a lens of one or more of a projector, a spectacle lens, an ophthalmic device, a contact lens, a corneal onlay, a corneal inlay, a corneal prosthesis, or an intraocular lens. good. For example, the lens comprises a spectacle lens with a light source positioned relative to the axis of astigmatism to provide peripheral stimulation and treat astigmatism as described herein. good too.

Lens 10 can be constructed in many ways and may comprise one or more of the contact lens components described with reference to FIGS. Lens 10 has an axis 80 . Contact lens 10 aligns axis 80 with an astigmatism axis of the eye, such as one or more of the refractive astigmatism axis or the corneal meridian, as described herein. Configured. The optic zone of the contact lens may comprise an optic zone, eg, a toric optic zone aligned with the astigmatism axis 80, configured to correct spherical and cylindrical ametropia. The contact lens may have a second astigmatism axis 81 that extends generally transversely to the first axis 80 . In some embodiments, the second astigmatism axis 81 is substantially perpendicular to the first astigmatism axis, eg, within about 80-100 degrees of the first astigmatism axis. at an angle. In the SMS embodiment, astigmatism axis 80 corresponds to the flatter meridian of the cornea and axis 81 corresponds to the steeper meridian of the cornea. The light sources, such as projection units 12a and 12b, are configured to provide stimulation to the retina at locations corresponding to the astigmatism axis of the eye. In some embodiments, the first light source and the second light source are located on opposite sides of an astigmatism axis or meridian and use retinal stimulation at a location corresponding to the first astigmatism axis or meridian. to treat astigmatism, and the light source can be configured to provide reduced illumination at a location corresponding to the second meridian.

In some embodiments, eye stimulation to correct astigmatism occurs along astigmatism meridians. A lens such as contact lens 10 may be stabilized against the eye, eg, stabilized on the eye. For example, in some embodiments, the lens is stabilized on the eye to orient the lens vertically. In some SMS embodiments, the projection unit 12 is positioned (e.g., symmetrically positioned) on opposite sides of the flatter meridian of the cornea, and the lens has astigmatism or It is stabilized so that it lies along the steep axis. In alternative embodiments (e.g., FMS embodiments), the projection unit 12 is positioned on opposite sides of the steeper meridians of the cornea (e.g., symmetrically positioned) to accommodate the flatter meridians of the cornea. is stabilized so that it lies along the astigmatic or flat axis. In some embodiments, the axis 80 comprises an axis of symmetry about which the projection units 12a, 12b lie symmetrically. The projection units 12a, 12b can be sized and shaped in many ways, but in some embodiments the projection units are arcuate in shape, corresponding to the sector of the ring, to provide circular stimulation to the retina. Have a profile. In some embodiments, light from the stimulus traverses the optical axis of the eye and illuminates arcuate regions of the retina on the opposite side of the eye.

In the example discussed in Table 1, the axis of the correction cylinder is at 90 degrees, and thus the contact lens 10 is preformed so that the astigmatism axis 80 of the lens 10 can be the flatter meridian of the cornea. can be stabilized in the eye so as to be substantially aligned with or parallel to the cylinder axis defined in the projection unit, the astigmatic meridian, etc., when the lens 10 is vertically stabilized. , project the image to a location relative to the astigmatic meridian of the cornea.

Contact lens 10 includes a ballast or weight that is asymmetrical such that gravity acts on the ballast or weight to stabilize the contact lens and pull it down in a direction that aligns the astigmatic meridian with the lens and its projection unit. It's okay. In some embodiments, the contact lens 10 is blink stabilized such that the patient's natural blink affects the shape of the contact lens, stabilizing and orienting the lens in the patient's eye. It may be molded as In some embodiments, other stabilization methods may be used to align the eye with lens 10 and its astigmatism axis.

In some embodiments, contact lens 10 may have a projection unit that is asymmetric with respect to contact lens 10 . In such embodiments, the projection unit on contact lens 10 may not have an axis of symmetry, but still such that projection unit 12 stimulates the eye at locations corresponding to astigmatic meridians. , can be aligned with the eye.

In the contact lens 10, one or more of the battery 20, the PCB 24, the sensor 22, or other components of the contact lens 10 stabilize the contact lens and align the stimulus with the astigmatism meridian of the eye. It may act as a ballast for In the example of Table 1, the predefined cylinder axis is 90 degrees and perpendicular to the patient's body. As shown in FIG. 9A, the battery 20, acting as a ballast, is aligned with the axis of symmetry 80 of the contact lens to align the axis of symmetry 80 with the horizontal 180 degree astigmatism meridian.

In some embodiments, the astigmatism cylinder correction axis may be at an angle other than 90 degrees. For example, a patient may have astigmatism cylindrical correction axis 80 at 80 degrees and axis 81 at 170 degrees. FIG. 9B shows contact lens 10 in which the ballast is positioned offset from the axis of astigmatism 80 of projection unit 12 such that axis 80 is aligned with the 80 degree astigmatism cylinder correction axis. In some embodiments, the shape of the contact lens, which enables blinking or other types of stabilization, is such that when the contact lens 10 is stabilized in the patient's eye, the projection unit aligns with the astigmatic meridian. It may be offset from the axis of symmetry of the projection unit so that it is positioned along. FIG. 9B also depicts microdisplay 12 in the shape of an annular sector.

According to some embodiments, soft contact lens 10 comprises a projection unit as described herein.

A processor on lens 10 is programmed or otherwise programmed with instructions to selectively illuminate the projection optics, project light onto multiple locations on the retina, and treat myopia and/or astigmatism. may be configured in the same manner. Selective illumination and concomitant stimulation and therapy may be performed as discussed with respect to FIG. 8 and steps 820 and 830. For example, in treating astigmatism, the processor of a lens such as that depicted in FIGS. 9A and 9B may be selectively controlled to illuminate and project an image onto the retina. In some embodiments, such as the contact lens shown in FIG. 2, the first group of optics, such as those arranged along the sharp meridians of the cornea, are selected along the sharp meridians of the retina. A second group of optics, such as those arranged along the flatter meridian of the cornea, may be selectively illuminated to treat one or both of astigmatism and myopia at the same location. may be selectively illuminated to treat myopia at selected locations of the retina along flatter meridians.

FIG. 10 depicts spectacles 70 as in FIGS. 7A and 7B configured for the treatment of refractive astigmatism. The spectacles 70 comprise a first astigmatism axis 80 and a second astigmatism axis 81 as described herein. The glasses can be configured for steep meridian stimulation (SMS) or flat meridian stimulation (FMS) as described herein. The spectacles may be programmed to provide stimulation and treat refractive errors, for example, using appropriate light source selection under processor control.

The microdisplay and optics can be configured in a number of ways to provide appropriate stimulation to the outer region of the retina towards the periphery. For example, FIG. 10 depicts four groups of pixels 94 94a, 94b, 94c, and 94d. For patients with refractive errors as discussed above with reference to Table 1, groups 94a and 94b may provide stimuli for treatment of astigmatism errors. Alternatively or in combination, groups 94a, 94b, 94c, and 94d may provide stimulation for treatment of spherical abnormalities.

For example, in some embodiments, in step 820, light or images are defocused on either side of axis 80 by groups 94a and 94b, as described herein, to correct for cylindrical refractive error. and stimulates choroidal thickness growth in the eye and provides differential scleral growth in the eye.

In some embodiments, in step 830, stimuli such as images are centered by groups 94a, 94b, 94c, and 94d as described hereinabove to correct for spherical refractive error. Provided to the retina eccentric to the fovea, it stimulates the growth of the choroidal thickness of the eye and reduces the increase in axial length of the eye centered within the peripheral area around the fovea.

Stimuli to correct cylindrical and spherical abnormalities may be provided separately or simultaneously. For example, in some embodiments, stimuli, such as images, are provided by groups 94a and 94b on either side of axis 80 to stimulate an increase in choroidal thickness of the eye and to correct for cylindrical refractive error. Provide differential scleral growth, such as differential growth of the sclera corresponding to axial length. As described herein, axis 80 may correspond to the steeper meridian of the cornea or the flatter meridian of the cornea. In some embodiments, groups 94c and 94d less than groups 94a and 94b are activated.

As discussed above with respect to FIGS. 8, 9A, and 9B, stimuli for correcting astigmatism and spherical aberration are provided at different intensities, amounts of defocusing, and different time-based periodic treatments. may

The spectacles are programmed or otherwise configured with instructions to selectively illuminate the projection optics, project light onto multiple locations on the retina, and treat myopia and/or astigmatism. may include one or more processors. The spectacles may comprise one or more of the mechanical integration components referenced in FIG. Selective illumination and concomitant stimulation and therapy may be performed as discussed with respect to FIG. 8 and steps 820 and 830. For example, in treating astigmatism, the processor may selectively control groups of one or more pixels to illuminate and project an image onto the retina. In some embodiments, the processor selectively illuminates at selected locations of the retina along steep meridians to illuminate the steep cornea to treat one or both of astigmatism and myopia. A first group of pixels, such as those arranged along the meridians, may be controlled, while a second group of pixels, such as those arranged along the flatter meridians of the cornea, may be controlled. Groups may be selectively illuminated at selected locations of the retina along flatter meridians to treat myopia.

FIG. 10 depicts a microdisplay with more than one active pixel in each group 94a, 94b, 94c, and 94d in some embodiments, although each group may contain a single pixel. . In some embodiments, only a single pixel or light source is used for stimulation along the steeper meridian and on both sides of the flatter meridian, e.g., for the treatment of astigmatic refractive error. good too.

Although the examples in Table 1 include an astigmatic refractive error at 90 degrees, in some embodiments the refractive error may be at other angles. FIG. 10 depicts an embodiment in which the first astigmatism axis 80 is at 80 degrees and the second astigmatism axis is at 170 degrees. In some embodiments, groups 94a and 94b of pixels 94 are symmetrically oriented about an astigmatism axis 80 to project defocused images transverse to the axis and to While correcting for astigmatism, groups 94c and 94d may also be rotated to provide stimuli such as defocused images and correct for spherical aberrations of the eye.

In some embodiments, the intensity and duration of activated pixels are configured to correspond to the astigmatic axis of treatment. For example, groups 94 a , 94 b , 94 c , and 94 d may each comprise pixels with different intensities or durations to compensate for different distances from astigmatism axis 80 . In some embodiments, each of the plurality of groups is a first stimulus having a first intensity and a first duration at a first distance from the astigmatism axis 80 and a first stimulus from the astigmatism axis. a second stimulus on a second side having a second intensity and a second duration at two distances. In some embodiments, for each of the plurality of groups 94a, 94b, 94c, 94d, one or more of the second intensity or the second duration is the first intensity or the first Compensating for a first difference, different than a second distance, different from one or more of the directions. This has the advantage of improving treatment accuracy and allowing for reduced pixel resolution.

For example, an eyeglass prescription may comprise a -2.00D cylinder with a prescription astigmatism axis with an angle of 75 degrees. The power of such a cylinder is located at 90 degrees, eg, 165 degrees from the prescription axis. Stimulation can be positioned at 180 and 150 degrees, respectively, for treatment at 165 degrees, for example. If both of those stimuli provide equal values of intensity and duration, the vector lies on the -2 power meridian of 165 degrees, which corresponds to a prescription of -2.00 x 75 degrees. Alternatively, one or more of the intensity or duration of stimulation can be adjusted to provide therapy corresponding to a different axis, eg, 164 degrees. For example, a first stimulus closer to the axis may have one or more of an intensity or duration that is less than or greater than an intensity or duration of a second stimulus farther from the axis.

Referring to the step of projecting an image onto the retina to treat astigmatism, stimulation can be provided in a number of ways. For example, stimulation can be provided using an illumination source that provides light to the retina without projecting an image into the eye. In some embodiments, the stimulus comprises scattered light that is passed through a scattering medium. The light scattering medium can be positioned relative to the lens in a similar manner as described herein with reference to the projection unit. Alternatively, the stimulus may be a pattern shown on a display for providing stimulus and treating astigmatism, similar to arcuate projection units 12a and 12b as described herein, e.g. may comprise an arcuate pattern of .

The amount and location of illumination on the outer location of the retina to provide astigmatism correction can be determined without undue experimentation by one of ordinary skill in the art following the teachings disclosed herein.

As described herein, the computing devices and systems described and/or illustrated herein are broadly defined as computer-readable modules, such as those contained within the modules described herein. Represents any type or form of computing device or system capable of executing instructions. In their most basic configuration, each of these computing devices may comprise at least one memory device and at least one physical processor.

The term "memory" or "memory device" as used herein generally refers to any type or form of volatile or nonvolatile storage device capable of storing data and/or computer readable instructions or represents the medium. In one example, a memory device may store, load, and/or maintain one or more of the modules described herein. Examples of memory devices include, but are not limited to, random access memory (RAM), read only memory (ROM), flash memory, hard disk drive (HDD), solid state drive (SSD), optical disk drive, cache, the same a variation or combination of one or more of or any other suitable storage memory.

Additionally, the term "processor" or "physical processor" as used herein generally refers to any type or form of hardware-implemented processing capable of interpreting and/or executing computer-readable instructions. point to the unit. In one embodiment, a physical processor may access and/or modify one or more modules stored within the memory devices described above. Examples of physical processors include, but are not limited to, microprocessors, microcontrollers, central processing units (CPUs), field programmable gate arrays (FPGAs) implementing soft core processors, application specific integrated circuits (ASICs), the same part of one or more of the same, variations or combinations of one or more of the same, or any other suitable physical processor; The processors may comprise distributed processor systems, eg, running parallel processors, or remote processors such as servers, and combinations thereof.

Although illustrated as separate elements, the method steps described and/or illustrated herein may represent parts of a single application. Additionally, in some embodiments, one or more of these steps, when performed by a computing device, instructs the computing device to perform one or more tasks, such as method steps. may represent or correspond to one or more software applications or programs that may implement the

In addition, one or more of the devices described herein convert data, physical devices, and/or representations of physical devices from one form to another. good too. Additionally or alternatively, one or more of the modules listed herein may execute on a computing device, store data on the computing device, and/or Convert the processor, volatile memory, non-volatile memory, and/or any other portion of the physical computing device from one form of computing device to another by interacting with the computing device differently. of computing devices.

The term "computer-readable medium" as used herein generally refers to any form of device, carrier, or medium capable of storing or carrying computer-readable instructions. Examples of computer readable media include, but are not limited to, transmission-type media such as carrier waves, and magnetic storage media (e.g., hard disk drives, tape drives, and floppy disks), optical storage media (e.g., compact discs), (CDs), digital video discs (DVDs), and BLU-RAY® discs), electronic storage media (e.g., solid state drives and flash media), and other distributed systems. Prepare.

A person skilled in the art will recognize that any process or method disclosed herein can be modified in many ways. The process parameters and sequence of steps described and/or illustrated herein are given as examples only and can be varied as desired. For example, although steps illustrated and/or described herein are shown or discussed in a particular order, the steps need not necessarily be performed in the order illustrated or discussed.

Various exemplary methods described and/or illustrated herein may also omit one or more of the steps described or illustrated herein, or perform steps in addition to those disclosed. may comprise additional steps. Further, the steps of any method as disclosed herein may be combined with any one or more steps of any other method as disclosed herein.

A processor as described herein may be configured to perform the steps of one or more of any method disclosed herein. Alternatively, or in combination, the processor may be configured to combine one or more steps of one or more methods as disclosed herein.

Unless stated otherwise, the terms "connected to" and "coupled to" (and derivatives thereof) as used herein and in the claims refer both directly and indirectly (i.e. , through other elements or components). Additionally, the terms "a" and "an" as used in the specification and claims are to be interpreted as meaning "at least one of". Finally, for ease of use, the terms "including" and "having" (and their derivatives) as used herein and in the claims are shall be synonymous with and have the same meaning as the word "comprising";

A processor as disclosed herein may be configured with instructions to perform the steps of any one or more of any method as disclosed herein.

The terms “first,” “second,” “third,” etc. are used herein to describe various layers, elements, components, regions or divisions, without referring to any particular order or sequence of events. It should be understood that it can be used in the specification. These terms are only used to distinguish one layer, element, component, region or section from another layer, element, component, region or section. A first layer, element, component, region or section as described herein could be referred to as a second layer, element, component, region or section without departing from the teachings of the present disclosure. obtain.

As used herein, the term "or" is used interchangeably and in combination to refer to items inclusively.

As used herein, letters such as numbers refer to like elements.

This disclosure includes the following numbered appendices.

Appendix 1. A device for treating astigmatism in an eye using retinal stimulation of the eye, comprising a light source configured to provide a stimulus to the retina of the eye, the stimulus being directed to the astigmatism axis of the eye. and configured to treat astigmatism in an eye.

Appendix 2. 2. The apparatus of Clause 1, wherein the stimulus comprises a first optical stimulus on the first side of the astigmatic axis and a second optical stimulus on the second side of the astigmatic axis.

Appendix 3. The first stimulus comprises a first intensity and a first duration at a first distance from the astigmatism axis and the second stimulus on the second side is a second distance from the astigmatism axis. at a distance with a second intensity and a second duration, wherein one or more of the second intensity or the second duration is at the first intensity or in the first direction 3. Apparatus according to clause 2, compensating for a first difference different from one or more and different from a second distance.

Appendix 4. The eye has a second axis of astigmatism, the first optical stimulus and the second optical stimulus illuminate the retina along the second axis of astigmatism, and the non-stimulus along the first axis. 3. Apparatus according to clause 2, arranged to reduce astigmatism.

Appendix 5. The light source is configured to illuminate the retina with a first light stimulus on a first side of the astigmatism axis and a second light stimulus on a second side of the astigmatism axis. The device of claim 1, wherein the device is

Appendix 6. 6. The apparatus of Clause 5, wherein the light source is configured to inhibit macular illumination with the first stimulus and the second stimulus.

Appendix 7. The light sources are arranged to provide light to a first region of the peripheral retina outside the macula and a second region of the peripheral retina outside the macula, the second region being in contact with the first region. 10. The apparatus of paragraph 1, wherein the macula of the retina is located between the first and second regions.

Appendix 8. The retina has a third area on the first side of the macula between the first and second areas and a third area on the second side of the macula between the first and second areas. and the light source is configured to provide a greater amount of light to the first and second regions than to the third and fourth regions. equipment.

Note 9. The four regions each constitute a quadrant of the retina, the first region corresponding to the first quadrant, the second region corresponding to the second quadrant, and the third region: 9. Apparatus according to clause 8, corresponding to the third quadrant and the fourth region corresponding to the fourth quadrant.

Appendix 10. A lens comprising an optic zone for the eye to view an object, and a plurality of images at a plurality of locations arranged around the optic zone and outside one or more of the fovea or the macula of the eye. in front of the retina of the eye, the plurality of optical systems aligned with the astigmatism meridian of the eye.

Appendix 11. 11. The apparatus of Clause 10, further comprising a processor coupled to the plurality of optical systems, the processor configured with instructions for projecting light to the plurality of locations.

Appendix 12. The plurality of optical systems use the first plurality of optical systems to treat astigmatism and the second plurality of optical systems and the first plurality of optical systems to treat myopia and astigmatism. the processor illuminates the first plurality of optical systems to treat astigmatism; illuminates the first plurality of optical systems and the second plurality of optical systems to treat myopia; 12. The apparatus of clause 11, configured with instructions for.

Appendix 13. A first plurality of optical systems are configured to deliver amounts of light for treating astigmatism corresponding to steep meridians of the cornea, and a second plurality of optical systems are configured to deliver amounts of light corresponding to steep meridians of the cornea. 13. The device of paragraph 12, configured to treat myopia corresponding to the flatter meridian of the cornea located 90 degrees from the meridian.

Appendix 14. 14. The apparatus of Clause 13, wherein the first plurality of optical systems is configured to pass through a sharper region of the cornea than the second plurality of optical systems.

Appendix 15. 14. The apparatus of Clause 13, wherein the first plurality of optical systems is configured to pass through a flatter area of the cornea than the second plurality of optical systems.

Appendix 16. The first plurality of optical systems and the second plurality of optical systems are each configured to transmit light transverse to the optical axis of the lens and project an image in front of the retina on opposite sides of the optical axis. 15. The apparatus of clause 14, wherein:

Appendix 17. 13. The apparatus of clause 12, wherein the processor is configured to treat myopia and astigmatism sequentially.

Appendix 18. 13. The apparatus of Clause 12, wherein the processor is configured with instructions for selectively illuminating each of the first plurality of optical systems and the second plurality of optical systems.

Appendix 19. The processor is programmable with instructions for selectively illuminating the second plurality of optical systems relative to astigmatism meridians on the eye, the lens positioned in front of the eye. 13. The device of clause 12, wherein the device is stabilized when:

Appendix 20. The astigmatic meridian corresponds to a corneal meridian having a steeper curvature than the curvature of the flatter meridian of the cornea, and the plurality of optics corresponds to the steeper meridian for scleral growth at the location of the sclera. 11. The apparatus of clause 10, configured to reduce , and reduce astigmatism in an eye.

Appendix 21. 21. The apparatus of paragraph 20, wherein the sharp meridians of the cornea correspond to lines along the retina, the lines extending through multiple locations.

Appendix 22. Supplementary Note 21: The plurality of optical systems are configured to reduce scleral growth at locations corresponding to steep meridians relative to scleral growth at locations away from locations corresponding to steep meridians. The apparatus described in .

Appendix 23. 21. The apparatus of paragraph 20, wherein the flatter meridian of the cornea corresponds to a line along the retina, the line extending through multiple locations.

Appendix 24. the plurality of optical systems configured to reduce scleral growth at locations corresponding to the flatter meridians relative to scleral growth at locations away from locations corresponding to the flatter meridians; 24. Apparatus according to clause 23.

Appendix 25. The astigmatic meridian corresponds to a corneal meridian that has a steeper curvature than the curvature of a flatter meridian of the cornea, and the plurality of optics directs scleral growth at a location of the sclera corresponding to the flatter meridian. 11. The device of clause 10, configured to reduce astigmatism in an eye.

Appendix 26. 11. The apparatus of Clause 10, wherein the plurality of optical systems are configured to facilitate variation of one or more of axial length or choroidal thickness of the eye to treat astigmatism.

Appendix 27. 11. The apparatus of Clause 10, wherein the plurality of optical systems are configured to transmit light across the optical axis of the lens and project an image in front of the retina on opposite sides of the optical axis.

Appendix 28. 11. The apparatus of clause 10, wherein the astigmatism meridians of the eye constitute sharp meridians of the cornea of the eye, and the plurality of locations of the retina correspond to the steep meridians.

Appendix 29. 29. of clause 28, wherein the optical axis of the lens extends from the object, through the optical zone, to the fovea of the eye, and light from multiple optical systems extends across the optical axis to multiple locations. Device.

Appendix 30. 30. The apparatus of Clause 29, wherein light from each of the plurality of optical systems extends to a corresponding location on the retina and traverses the optical axis.

Appendix 31. The lens includes a stabilizing mechanism to orient the lens vertically along the eye, and the plurality of optical systems align the light with the astigmatic meridian with the lens vertically stabilized on the eye. 11. The device of clause 10, arranged to be directed at the

Appendix 32. 32. The device of clause 31, wherein the lens comprises a contact lens, and the contact lens comprises a contact lens stabilization mechanism.

Appendix 33. 32. The apparatus of clause 31, wherein the lens comprises a spectacle lens, and the spectacle lens is supported with a spectacle frame.

Appendix 34. 11. The apparatus of Clause 10, wherein each of the plurality of optical systems is configured to project an image to a location anterior or posterior to the corresponding retinal location to treat astigmatism.

Appendix 35. 11. The apparatus of Clause 10, wherein each of the plurality of optical systems is configured to project an image in front of the retina at a corresponding retinal location.

Appendix 36. 36. The apparatus of Clause 35, wherein the lenses comprise spectacle lenses and the plurality of optical systems are adjusted to reduce the effects of astigmatism exerted by the imaging location in front of the retina.

Appendix 37. 11. The lens of clause 10, wherein the lens comprises a spectacle lens and the eye position sensor is configured to adjust the plurality of optical systems and reduce movement of the plurality of locations on the retina in response to eye movement. Device.

Appendix 38. 11. The apparatus of clause 10, wherein the lens comprises one or more of a plano lens, a spherically corrected lens, an astigmatism corrected lens, or a prism corrected lens.

Appendix 39. A method of treating an eye, comprising providing a stimulus to the retina of the eye, the stimulus being aligned with an astigmatism axis of the eye to treat astigmatism of the eye.

Appendix 40. 40. The method of Clause 39, wherein the stimulus comprises a first optical stimulus on the first side of the astigmatic axis and a second optical stimulus on the second side of the astigmatic axis.

Appendix 41. The first stimulus comprises a first intensity and a first duration at a first distance from the astigmatism axis and the second stimulus on the second side is a second distance from the astigmatism axis. at a distance with a second intensity and a second duration, wherein one or more of the second intensity or the second duration is at the first intensity or in the first direction 41. The method of clause 40, compensating for a first difference that is different from one or more and different from a second distance.

Appendix 42. The eye has a second axis of astigmatism, and the first optical stimulus and the second optical stimulus are arranged along the second axis of astigmatism to produce astigmatism along the first axis. 41. The method of paragraph 40, wherein the method is reduced.

Appendix 43. 40. The method of Clause 39, wherein the stimulus is configured to inhibit macular illumination with the first stimulus and the second stimulus.

Appendix 44. The stimuli are arranged to provide light to a first region of the peripheral retina outside the macula and a second region of the peripheral retina outside the macula, the second region being in contact with the first region. 40. The method of clause 39, wherein the macula of the retina is located between the first and second regions.

Appendix 45. The retina has a third area on the first side of the macula between the first and second areas and a third area on the second side of the macula between the first and second areas. 45. The method of clause 44, wherein the stimulus provides a greater amount of light to the first and second regions than to the third and fourth regions.

Note 46. The four regions each constitute a quadrant of the retina, the first region corresponding to the first quadrant, the second region corresponding to the second quadrant, and the third region: 46. The method of clause 45, corresponding to a third quadrant, and wherein the fourth region corresponds to the fourth quadrant.

Appendix 47. A method or apparatus according to any one of the preceding notes, wherein the astigmatism axis corresponds to the cylinder axis with the + cylinder notation.

Appendix 48. A method or apparatus according to any one of the preceding notes, wherein the astigmatism axis corresponds to the cylinder axis - with the cylinder notation.

Embodiments of the disclosure, while illustrated and described herein, are provided by way of example only. Those skilled in the art will recognize numerous adaptations, modifications, variations and substitutions without departing from the scope of this disclosure. Several alternatives and combinations of the embodiments disclosed herein may be utilized without departing from the scope of this disclosure and the inventions disclosed herein. Accordingly, the scope of the disclosed invention shall be defined only by the scope of the appended claims and their equivalents.

Claims (48)

A device for treating astigmatism in an eye using retinal stimulation of said eye, said device comprising:
a light source configured to provide a stimulus to the retina of the eye, the stimulus aligned with an astigmatism axis of the eye and configured to treat astigmatism of the eye; Device. 2. The stimulus of claim 1, wherein the stimulus comprises a first light stimulus on a first side of the astigmatism axis and a second light stimulus on a second side of the astigmatism axis. Device. The first stimulus has a first intensity and a first duration at a first distance from the astigmatism axis, and the second stimulus on the second side is directed to the astigmatism axis. at a second distance from the axis, comprising a second intensity and a second duration, wherein one or more of said second intensity or said second duration is at said first intensity or different from one or more of said first directions to compensate for a first difference different from said second distance. The eye has a second axis of astigmatism, the first optical stimulus and the second optical stimulus illuminate the retina along the second axis of astigmatism; 3. Apparatus according to claim 2, arranged to reduce astigmatism along the axis of . The light source illuminates the retina with a first light stimulus on a first side of the astigmatism axis and a second light stimulus on a second side of the astigmatism axis. 2. The apparatus of claim 1, configured to: 6. The apparatus of claim 5, wherein the light source is configured to inhibit macular illumination using the first stimulus and the second stimulus. The light sources are arranged to provide light to a first area of the peripheral retina outside the macula and a second area of the peripheral retina outside the macula, the second area comprising the second area of the retina outside the macula. 2. The device of claim 1, opposite one region, wherein the macula of the retina is located between the first region and the second region. The retina has a third region between the first region and the second region on the first side of the macula, and the first region and the second region on the second side of the macula. and a fourth region between the light source and the second region, wherein the light source directs a greater amount of light to the first region and the second region than the third region and the fourth region. 8. Apparatus according to claim 7, configured to provide. The four regions each constitute a quadrant of the retina, the first region corresponding to the first quadrant, the second region corresponding to the second quadrant, and the third region. corresponds to the third quadrant and the fourth region corresponds to the fourth quadrant. a lens comprising an optical zone for viewing objects by the eye;
a plurality of optical systems arranged around the optical zone for projecting images in front of the retina of the eye at locations outside one or more of the fovea or the macula of the eye; 2. The apparatus of claim 1, further comprising: a plurality of optical systems arranged with respect to an astigmatism meridian of the eye. 11. The apparatus of Claim 10, further comprising a processor coupled to said plurality of optical systems, said processor configured with instructions for projecting light to said plurality of locations. The plurality of optical systems use a first plurality of optical systems to treat astigmatism, and a second plurality of optical systems and the first plurality of optical systems to treat myopia and astigmatism. wherein the processor illuminates the first plurality of optical systems, treats the astigmatism, illuminates the first plurality of optical systems and the second plurality of optical systems and configured with instructions for treating said myopia. The first plurality of optical systems are configured to deliver an amount of light to treat the astigmatism corresponding to steep meridians of the cornea, and the second plurality of optical systems are adapted to 13. The device of claim 12, configured to treat myopia corresponding to the flatter meridian of the cornea located 90 degrees from the steep meridian of the cornea. 14. The apparatus of claim 13, wherein the first plurality of optical systems are configured to pass through a sharper region of the cornea than the second plurality of optical systems. 14. The apparatus of claim 13, wherein the first plurality of optical systems are configured to pass through a flat region of the cornea more than the second plurality of optical systems. Each of said first plurality of optical systems and said second plurality of optical systems transmits light transversely to the optical axis of said lens and directs an image in front of said retina on opposite sides of said optical axis. 15. Apparatus according to claim 14, configured to project. 13. The apparatus of Claim 12, wherein the processor is configured to treat the myopia and astigmatism sequentially. 13. The apparatus of Claim 12, wherein said processor is configured with instructions for selectively illuminating each of said first plurality of optical systems and said second plurality of optical systems. The processor is programmable with instructions for selectively illuminating the second plurality of optical systems relative to astigmatic meridians on the eye, wherein the lens is positioned in front of the eye. 13. The device of claim 12, wherein the device is stabilized when placed in a The astigmatism meridian corresponds to a corneal meridian having a steeper curvature than the curvature of the flatter meridian of the cornea, and the plurality of optical systems aligns the corneal meridian at a location on the sclera corresponding to the steeper meridian. 11. The device of claim 10, configured to reduce scleral growth and reduce astigmatism of the eye. 21. The apparatus of claim 20, wherein the steep meridians of the cornea correspond to lines along the retina, the lines extending through the plurality of locations. The plurality of optical systems are configured to reduce scleral growth at locations corresponding to the steep meridians relative to growth of the sclera at locations remote from the locations corresponding to the steep meridians. 22. Apparatus according to claim 21, wherein the apparatus is configured. 21. The apparatus of claim 20, wherein the flatter meridian of the cornea corresponds to a line along the retina, the line extending through the plurality of locations. The plurality of optical systems are configured to reduce growth of the sclera at locations corresponding to the flatter meridians relative to growth of the sclera at locations away from locations corresponding to the flatter meridians. 24. The apparatus of claim 23, wherein the apparatus is configured for: The astigmatic meridian corresponds to a corneal meridian having a steeper curvature than the curvature of the flatter meridian of the cornea, and the plurality of optical systems aligns the corneal meridian at a location on the sclera corresponding to the flatter meridian. 11. The device of claim 10, configured to reduce scleral growth and reduce astigmatism of the eye. 11. The optical systems of claim 10, wherein the plurality of optical systems are configured to facilitate variation of one or more of axial length or choroidal thickness of the eye to treat the astigmatism. Device. 11. The optical systems of claim 10, wherein the plurality of optical systems are configured to transmit light across an optical axis of the lens and project an image forward of the retina on opposite sides of the optical axis. device. 11. The apparatus of claim 10, wherein astigmatism meridians of the eye constitute steep meridians of the cornea of the eye, and locations of the retina correspond to the steep meridians. An optical axis of the lens extends from the object, through the optical zone, to the fovea of the eye, and light from the plurality of optical systems extends across the optical axis to the plurality of locations. 29. The apparatus of claim 28, wherein: 30. The apparatus of Claim 29, wherein light from each of said plurality of optical systems extends to a corresponding location on said retina and traverses said optical axis. The lens includes a stabilizing mechanism to orient the lens vertically along the eye, and the plurality of optical systems are configured to align the lens with the lens vertically stabilized on the eye. 11. Apparatus according to claim 10, arranged to direct light to said astigmatic meridians. 32. The device of claim 31, wherein the lens comprises a contact lens, and wherein the contact lens comprises a contact lens stabilization mechanism. 32. The apparatus of claim 31, wherein said lens comprises a spectacle lens, said spectacle lens being supported using a spectacle frame. 11. The apparatus of claim 10, wherein each of said plurality of optical systems is configured to project an image to a location anterior or posterior to a corresponding retinal location to treat said astigmatism. 11. The apparatus of claim 10, wherein each of said plurality of optical systems is configured to project an image in front of said retina at a corresponding retinal location. 36. The apparatus of claim 35, wherein the lenses comprise spectacle lenses and the plurality of optical systems are adjusted to reduce astigmatism effects of an imaging location in front of the retina. . 10. The lens comprises a spectacle lens, and the eye position sensor is configured to adjust the plurality of optical systems to reduce movement of locations on the retina in response to eye movement. 11. The device according to 10. 11. The apparatus of claim 10, wherein the lens comprises one or more of a plano lens, a spherical correction lens, an astigmatism correction lens, or a prism correction lens. A method of treating an eye, said method comprising:
A method comprising providing a stimulus to a retina of said eye, said stimulus being aligned with an astigmatism axis of said eye to treat astigmatism of said eye. 40. The method of claim 39, wherein said stimulus comprises a first light stimulus on a first side of said astigmatism axis and a second light stimulus on a second side of said astigmatism axis. Method. The first stimulus has a first intensity and a first duration at a first distance from the astigmatism axis, and the second stimulus on the second side is directed to the astigmatism axis. at a second distance from the axis, comprising a second intensity and a second duration, wherein one or more of said second intensity or said second duration is at said first intensity or different from one or more of said first directions to compensate for a first difference different from said second distance. The eye has a second axis of astigmatism, the first optical stimulus and the second optical stimulus are arranged along the second axis of astigmatism and along the first axis. 41. The method of claim 40, which reduces astigmatism. 40. The method of claim 39, wherein the stimulus is configured to inhibit macular illumination using the first stimulus and the second stimulus. The stimulus is arranged to provide light to a first region of the peripheral retina outside the macula and a second region of the peripheral retina outside the macula, the second region comprising: 40. The method of claim 39, wherein opposite one region, the macula of the retina is located between the first region and the second region. The retina has a third region between the first region and the second region on the first side of the macula, and the first region and the second region on the second side of the macula. and a fourth region between the second region, wherein the stimulus directs a greater amount of light to the first region and the second region than to the third region and the fourth region. 45. The method of claim 44, wherein: The four regions each constitute a quadrant of the retina, the first region corresponding to the first quadrant, the second region corresponding to the second quadrant, and the third region. 46. The method of claim 45, wherein corresponds to the third quadrant and the fourth region corresponds to the fourth quadrant. 4. A method or apparatus according to any one of the preceding claims, wherein the astigmatism axis corresponds to the cylinder axis with the +cylindrical notation. A method or apparatus according to any one of the preceding claims, wherein the astigmatism axis corresponds to the cylinder axis with the -cylindrical notation.

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